- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,135.61 / $21,877.62
| Facility | | $10,000.00 | $15,135.61 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $12,022.64 / $18,197.01
| Facility | | $8,317.64 | $12,022.64 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $12,022.64 / $20,892.96
| Facility | | $8,709.64 | $12,022.64 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $11,481.54 / $19,952.62
| Facility | | $6,606.93 | $11,481.54 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $9,332.54 / $15,488.17
| Facility | | $5,888.44 | $9,332.54 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $15,135.61 / $21,877.62
| Facility | | $7,413.10 | $15,135.61 | $21,877.62 |